Do Women With Gestational Diabetes Need to Prepare for C-Sections?

About three to twelve percent of all pregnant women develop gestational diabetes, a condition which means high blood sugars that begins with pregnancy and often resolves itself after the mother gives birth. It is diagnosed between weeks twenty-four and twenty-eight of the pregnancy. Symptoms of gestational diabetes (GDM) are:

• extreme thirst


• hunger, or


• fatigue

but many women do not notice these symptoms. GDM is a common pregnancy-related health problem, and is in the same league as other pregnancy-related conditions that develop during the second or third trimesters, such as high blood pressure.

Gestational diabetes is associated with a number of complications, and women who have this form of diabetes are very likely to be asked to schedule a Caesarian section. In fact, some obstetricians won't even consider letting a mother with GDM deliver on her own schedule. They only offer induced labor or a pre-planned Caesarian delivery. But what are the risks?

Women who have C-sections compared to women who have normal delivery are:

• much more likely to suffer injury to the bladder and uterus, and up to 50 times more likely to suffer postpartum infections and blood clots in the legs or lungs


• twice as likely to be readmitted to the hospital


• much more likely to suffer pelvic adhesions, which are scar tissue causing problems with urination, defecation, and sexual intercourse


• at much greater risk in their next pregnancy to suffer placenta accreta, where the placenta forms an abnormally deep attachment to the wall of the uterus... requiring an abortion to save the life of the mother

And women who have C-sections have a one in four chance of still having pain at the surgical site six months after surgery.

About one in four babies is delivered by cesarean section, or C-section, which is a surgical procedure that is essentially "abdominal delivery".

Babies delivered by cesarean are more likely to:

• suffer accidental cuts by the surgeon


• have low Apgar scores and require admission to intensive care, and


• develop either pulmonary hypertension or type 1 diabetes later in life

A normal delivery is the goal for both mother and child. For mothers who have gestational diabetes, the best way to be able to deliver the baby without surgery is to keep blood sugar levels below 90 mg/dL (5 mmol/L) essentially all the time. It's a real challenge, but it confers a lifetime of rewards, the lifetime of the child.

Gestational diabetes usually takes the form of Type 2 diabetes in that it can be managed through diet and close monitoring of blood sugar levels.